Evaluation of cerebral artery perforators and the pipeline embolization device using optical coherence tomography

IntroductionOptical coherence tomography (OCT) provides high resolution imaging of tissue; this technology has been validated using intra-arterial catheters in the evaluation of arterial anatomy, pathology and treatments. The perforating cerebral arteries and intracranial stents have not been previously visualized with an OCT catheter.MethodsUsing a standard transfemoral endovascular technique, a LightLab C7 Dragonfly catheter was inserted in the middle and posterior cerebral arteries of a fresh frozen cadaver. OCT images of the cerebral vessels and a deployed Pipeline Embolization Device were acquired using the LightLab C7-XR OCT Intravascular Imaging System.ResultsDistal cerebral artery access with the imaging catheter was feasible via the femoral artery using a distal access catheter instead of the standard monorail system used in coronary investigations. Imaging of perforators and stent struts had exceptional resolution.ConclusionThe first use of a commercial OCT catheter in the evaluation of intracranial vessels using transfemoral endovascular techniques is described. Challenges of intracranial OCT include blood clearance and vessel tortuosity. This technology may aid in the diagnosis and treatment of cerebrovascular disease in the future.